Our Summary

This research paper is about a condition called Valgus Extension Overload Syndrome (VEOS), which often affects athletes who use overhead movements, such as baseball players. VEOS includes a range of elbow problems, including ulnar collateral ligament (UCL) injuries, which are very common in these athletes.

Some athletes with UCL injuries also show signs of other VEOS conditions. Because of this, many doctors recommend a procedure called arthroscopy at the same time as they repair the UCL. This allows them to diagnose and treat other VEOS conditions. However, it’s not clear if this approach actually reduces the need for more surgeries for VEOS conditions later on.

The researchers wanted to find out if performing routine diagnostic arthroscopy (RDA) in patients undergoing UCL repair was linked to fewer future surgeries for VEOS conditions. They looked at 25 studies involving 2118 cases of UCL repair.

Their findings showed that the percentage of future surgeries for VEOS conditions was slightly lower when UCL repair was done with RDA. However, the difference was not significant enough to show that RDA reduces the need for more surgeries.

In conclusion, the researchers found that RDA does not significantly reduce the number or rate of future surgeries for other VEOS conditions. They also noticed that fewer doctors are using RDA with UCL repair over time for athletes with torn UCLs but no other known symptomatic VEOS conditions. This trend seems to be justified based on their findings.

FAQs

  1. What is Valgus Extension Overload Syndrome (VEOS) and who does it typically affect?
  2. What is the purpose of performing routine diagnostic arthroscopy (RDA) during UCL repair?
  3. Does performing RDA during UCL repair reduce the need for future surgeries for VEOS conditions according to the research findings?

Doctor’s Tip

Therefore, a helpful tip a doctor might tell a patient undergoing elbow surgery, specifically UCL repair for athletes with VEOS conditions, is that while routine diagnostic arthroscopy may be performed at the same time, it may not necessarily reduce the need for future surgeries for other VEOS conditions. It’s important for patients to follow their post-operative care plan, including physical therapy and proper rehabilitation, to help prevent further injuries and complications. Additionally, patients should communicate with their healthcare team about any ongoing symptoms or concerns to ensure they receive appropriate follow-up care.

Suitable For

Overall, patients who are typically recommended elbow surgery are athletes, particularly baseball players, who have UCL injuries and other VEOS conditions. In some cases, doctors may recommend performing a diagnostic arthroscopy at the same time as the UCL repair to diagnose and treat other VEOS conditions. However, based on the research findings, routine diagnostic arthroscopy does not significantly reduce the need for future surgeries for VEOS conditions. As a result, fewer doctors are using RDA with UCL repair over time for athletes with torn UCLs but no other known symptomatic VEOS conditions.

Timeline

Overall, the timeline for a patient before and after elbow surgery for VEOS may look like this:

Before surgery:

  1. Patient experiences symptoms of VEOS, such as pain and decreased range of motion in the elbow.
  2. Patient undergoes diagnostic tests to confirm the presence of VEOS conditions, such as UCL injuries.
  3. Doctor recommends UCL repair surgery with or without RDA to diagnose and treat other VEOS conditions.
  4. Patient undergoes pre-operative evaluations and tests to prepare for surgery.

After surgery:

  1. Patient undergoes UCL repair surgery, possibly with RDA.
  2. Patient goes through post-operative care, including physical therapy and rehabilitation to regain strength and range of motion in the elbow.
  3. Patient may experience pain and swelling in the elbow in the immediate post-operative period.
  4. Patient follows up with doctor for regular check-ups to monitor healing and progress.
  5. Patient may or may not require additional surgeries for other VEOS conditions in the future, regardless of whether RDA was performed during the initial UCL repair surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about elbow surgery for VEOS conditions include:

  1. What specific VEOS conditions do I have and how will they be addressed during the surgery?
  2. What is the likelihood that I will need additional surgeries for VEOS conditions in the future?
  3. What are the potential risks and complications associated with the surgery?
  4. What is the recovery process like and what type of rehabilitation will be necessary?
  5. Are there any alternative treatment options to consider before undergoing surgery?
  6. How experienced are you in performing UCL repairs and diagnostic arthroscopy for VEOS conditions?
  7. What is the success rate of this surgery in athletes with similar VEOS conditions?
  8. How long will it take for me to return to my sport or normal activities after the surgery?
  9. Are there any specific precautions or modifications I should take in my training or playing routine to prevent future VEOS conditions?
  10. What follow-up care will be needed after the surgery to monitor for any potential issues or complications?

Reference

Authors: Looney AM, Bovill JD, Huffman SS, Najarian RG. Journal: J Shoulder Elbow Surg. 2022 Jan;31(1):e22-e36. doi: 10.1016/j.jse.2021.08.004. Epub 2021 Aug 31. PMID: 34478864